SARS-CoV-2 Viral Load on Admission Is Associated With 30-Day Mortality

  1. Andrew Bryan
  2. Susan L Fink
  3. Meghan A Gattuso
  4. Gregory Pepper
  5. Anu Chaudhary
  6. Mark H Wener
  7. Chihiro Morishima
  8. Keith R Jerome
  9. Patrick C Mathias
  10. Alexander L Greninger

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Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load on admission was associated with a significantly increased 30-day mortality (odds ratio [OR], 4.20; 95% CI, 1.62–10.86), and anti-SARS-CoV-2 nucleocapisid IgG seropositivity on admission trended toward a reduced 30-day mortality (OR, 0.43; 95% CI, 0.15–1.26). Reporting of quantitative SARS-CoV-2 viral load and serologic assays may offer prognostic clinical information.

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  1. Version published to 10.1093/ofid/ofaa535
  2. ScreenIT

    SciScore for 10.1101/2020.05.22.20110551: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: The study was approved under a consent waiver by the University of Washington IRB.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Anti-SARS-CoV-2 nucleocapsid IgG was determined by the Abbott Architect as previously described [1].
    Abbott Architect
    suggested: (Abbott ARCHITECT i1000sr System, RRID:SCR_019328)
    Visualization was performed using ggplot2 [7].
    ggplot2
    suggested: (ggplot2, RRID:SCR_014601)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    The main limitation of our study was the retrospective nature in a population enriched for hospitalized patients with acute disease. The retrospective nature precluded analyses of viral clearance and length of stay due to significant confounding factors associated with RT-PCR testing frequency during admission and patient discharge placement. Although we had insufficient sample size to perform separate analyses with patients who only presented to the emergency department or outpatient clinic, results appeared similar to the full data set (Figure S2). Our serological test detects IgG antibodies against the nucleocapsid protein of SARS-CoV-2, and the correlation between these antibodies and neutralizing antibody responses is unknown. Variability in neutralizing responses between patients not elucidated by our assay may explain some of the variation in our data set. However, neutralizing antibody assays are in vitro methods that may or may not be associated with clinically meaningful outcomes unless performed in concert with challenge studies. In addition, non-neutralizing antibodies may also confer protection against infection in some viral infections [9]. Our work illustrates the importance of serological testing for SARS-CoV-2 infection. The association of the presence of anti-SARS-CoV-2 nucleocapsid IgG with lower viral load indicates antibodies may serve as a biomarker for COVID-19 disease course and infectious risk of the individual to the community.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.05.22.20110551 on medRxiv